Strategy for treatment of subtrochanteric femur fractures in children and adolescents

Abstract

Objective To evaluate the treatment methods for subtrochanteric femur fractures in children and adolescents.Methods Sixty-two patients (at age of 4-16 years) with subtrochanteric fe-mur fractures were managed with traction and delayed hip spica (14 patients, set as nonoperative group) ,titanium elastic nails or pin combined with cast (38 patients, set as less invasive group) and plates (10 patients, set as traditional operative group).The radiologic outcomes, hip joint function and complica-tions of the patients were analyzed.Results According to Beaty scoring, five patients in nonoperative group and 44 in operative group obtained satisfactory early radiologic outcomes.Late radiologic outcome was satisfactory in nine patients from nonoperative group and 46 from operative group according to Theolo-gis scoring, with statistical differences between two groups (P 0.05).Less invasive group and traditional operative group showed significantly statistical different in aspects of complications and Sanders scores (P < 0.05).Conclusions Operative treatment provides more satisfactory early and late radiologic results than nonoperative methods.Less invasive operations have better outcomes than tra-ditional operative methods.Selection of treatment modalities based on age, body weight, fracture features and soft tissue conditions of children is the prerequisite for a good outcome. Key words: Femoral fractures; Fracture fixation; internal; Titanium elastic nails